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AMPSS MEMBERSHIP APPLICATION

Are you classified as a: 

What population do you generally work with?

Choose from below

,please list:

ANNUAL DUES ARE DUE IN JUNE OF EACH YEAR

Select an item ($)

Individual or youth who is or is not a mental health consumer, or family member thereof. 

Family-Run, Youth or Peer Run Organization. This will include two (2) people from the organization.  Additional members must pay dues according to #1 and #2 .

Non-Profit Organization that is NOT family-run or youth-run. This membership will include two (2) people from that organization.  Additional members must pay dues according to #1 and #2.

Corporate Entity: This membership includes two people from that organization.  Additional members must pay dues according to #1 and #2. 

Membership will be granted upon approval of a submitted registration and annual dues. Annual dues are due in June of each year. Membership is non-refundable and non-transferable. The Board may approve, on a case by case basis and application, the membership for any person or entity that cannot afford its annual fee as a form of temporary scholarship.

Thank You!

You can also download an application and mail it with the membership fee to:

AMPSS 4803 Harrison Circle,

Gulfport, MS 39507

Click Here to Download

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